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Separation & Divorce: Financial Information Questionnaire

The financial aspects of divorce include child support, spousal support (often called alimony or spousal maintenance), and property and debt division. Decisions about these aspects of your divorce can be complicated and have long-lasting implications. It is therefore often smart to seek the counsel and representation of an experienced family law attorney to help you through the process and ensure an outcome that meets your needs not only now, but in the future as well. In order to do the best possible job on your behalf, your attorney needs your input and cooperation. You should be prepared to provide him or her with the following information:

INFORMATION ABOUT
YOU
INFORMATION ABOUT
YOUR SPOUSE
Gross Monthly Income
Source/Amount
________________/$________ __________________/$________
Source/Amount
________________/$________ __________________/$________
Source/Amount
________________/$________ __________________/$________
TOTAL:
$________________ $________________
Deductions from Gross Income
State Income Tax
$____________________ $____________________
Federal Income Tax
$____________________ $____________________
Social Security
$____________________ $____________________
Self-employment Tax
$____________________ $____________________
Health Insurance
$____________________ $____________________
Union Dues
$____________________ $____________________
Pension/Retirement
$____________________ $____________________
Mandatory?
Yes ____ No ____ Yes ____ No ____
Support Orders
$____________________ $____________________
Other
$____________________ $____________________
TOTAL DEDUCTIONS:
$____________________ $____________________
NET MONTHLY INCOME: (gross income minus total deductions)
$____________________ $____________________
Monthly Expenses
Rent or Mortgage
$____________________ $____________________
Utilities:
Telephone
$____________________ $____________________
Gas
$____________________ $____________________
Electricity
$____________________ $____________________
Water & Sewer
$____________________ $____________________
Garbage Collection
$____________________ $____________________
Cable Television
$____________________ $____________________
Cellular Phone
$____________________ $____________________
Internet Service
$____________________ $____________________
Property Taxes
$____________________ $____________________
Insurance:
Medical
$____________________ $____________________
Dental
$____________________ $____________________
Life
$____________________ $____________________
Disability
$____________________ $____________________
Long-term Care
$____________________ $____________________
Homeowners/Renters
$____________________ $____________________
Auto(s)
$____________________ $____________________
Recreational Vehicle
$____________________ $____________________
Debt Payments:
Vehicle #1
$____________________ $____________________
Vehicle #2
$____________________ $____________________
Home Equity Loan
$____________________ $____________________
Student Loan
$____________________ $____________________
Other Loans
$____________________ $____________________
Credit Card #1
$____________________ $____________________
Credit Card #2
$____________________ $____________________
Credit Card #3
$____________________ $____________________
Educational Expenses:
For Self
$____________________ $____________________
For Children
$____________________ $____________________
Day Care:
For Children
$____________________ $____________________
For Parent(s)
$____________________ $____________________
Transportation Expenses:
Gasoline
$____________________ $____________________
Parking/Commuting
$____________________ $____________________
Vehicle Maintenance
$____________________ $____________________
Licenses
$____________________ $____________________
Food:
Groceries
$____________________ $____________________
Take-out Food
$____________________ $____________________
Restaurants
$____________________ $____________________
School Lunches
$____________________ $____________________
Clothing:
For Self
$____________________ $____________________
For Children
$____________________ $____________________
Repair and Cleaning
$____________________ $____________________
Household Expenses:
Cleaning Supplies
$____________________ $____________________
Cleaning Service
$____________________ $____________________
Yard Maintenance
$____________________ $____________________
Home Maintenance
$____________________ $____________________
Home Security
$____________________ $____________________
Home Improvements
$____________________ $____________________
Home Furnishings
$____________________ $____________________
Appliances
$____________________ $____________________
Uninsured Health-care Costs:
Medical
$____________________ $____________________
Dental
$____________________ $____________________
Prescriptions
$____________________ $____________________
Non-prescription
$____________________ $____________________
Personal Expenses:
Grooming
$____________________ $____________________
Entertainment
$____________________ $____________________
Travel
$____________________ $____________________
Gifts
$____________________ $____________________
Hobbies
$____________________ $____________________
Babysitting
$____________________ $____________________
Pet-care Costs
$____________________ $____________________
Donations
$____________________ $____________________
Other Expenses
$____________________ $____________________
$____________________ $____________________
$____________________ $____________________
$____________________ $____________________
TOTAL EXPENSES:
$____________________ $____________________
Assets
Value / Owe (where appropriate) Value / Owe (where appropriate)
Primary Home
$____________________ $____________________
Vacation Home
$____________________ $____________________
Other Home/Property
$____________________ $____________________
Vehicle(s)
$____________________ $____________________
Recreational Vehicle
$____________________ $____________________
Boat(s)
$____________________ $____________________
Furniture
$____________________ $____________________
Home Furnishings
$____________________ $____________________
Appliances
$____________________ $____________________
Artwork
$____________________ $____________________
Jewelry
$____________________ $____________________
Computer(s)
$____________________ $____________________
Personal Property
$____________________ $____________________
Cash
$____________________ $____________________
Stocks/Bonds/Funds
$____________________ $____________________
Stock Options
$____________________ $____________________
Checking Account(s)
$____________________ $____________________
Savings Account(s)
$____________________ $____________________
Retirement/Pensions
$____________________ $____________________
Profit Sharing
$____________________ $____________________
IRA(s)
$____________________ $____________________
Business(es)
$____________________ $____________________
Life Insurance
$____________________ $____________________
Other Assets

 





Description / Value

 




Description / Value

 



TOTAL ASSETS:
$____________________ $____________________
Educational Degrees
_______________________ _______________________
_______________________ _______________________
Separate Property (including property you or your spouse had before the marriage or received individually as a gift or inheritance during the marriage)
Description / Value

 




Description / Value

 




Next Steps
Contact a qualified divorce attorney to make sure
your rights are protected.
(e.g., Chicago, IL or 60611)

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